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PHOTO: PHOTO: PABLO TOSCO / OXFAM
COMMUNICABLE DISEASES
TAKING ACTION TO SAVE LIVES
What more can be done to help those aff ected by the Ebola crisis? We explore the eff orts being made by organisations, local authorities and members of the community
WORLD AIDS DAY Exploring the global impact
of HIV and AIDS
TACKLING MALARIA Unprecedented progress
is being made
A spotlight on
communicablediseases.co.uk
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Each year on World AIDS Day, we refl ect on the global impact of HIV, remember the 36 million people who have died from AIDS worldwide and show our solidarity and support for the 35 million people living with HIV today. It is also an important time to reflect on communicable diseases more broadly, and the devastating human impact these continue to have around the world.
Addressing the social, political and structural drivers of epidemics
What do m a l a r -ia, Ebola, hepatitis and TB have in common
with HIV? All are serious infections caused by a virus or bacteria, which people acquire following contact with other people (or animals, in the case of malaria). Unlike serious non-communicable diseases such as can-cer and cardiovascular disease, we can pinpoint a specifi c and singular cause for someone’s illness. We can say with certainty that without this exposure, the illness would be prevented. Phe-nomenal scientifi c advances have been made in our understanding of how these diseases work, how to pre-vent and how to treat them. Yet we have so far failed to tackle these con-ditions once and for all.
There are clearly individual, behav-ioural and environmental risk fac-tors associated with these infections, but these alone do not explain the unequal burden of communicable
disease globally, and within in-dividual regions. We need to look carefully at the social, political and structural drivers of epidemics. Without addressing these factors, we will never achieve our potential to end new infections and improve the lives of people living with seri-ous communicable diseases.
HIV is the perfect example of how crucial a whole-of-society approach is to an eff ective response to com-municable disease. It is signifi cant that despite major announcements on research into the HIV cure, one of the strongest messages from the International AIDS Conference held in Melbourne this year was an international call for human rights and non-discrimination for people living with HIV. HIV is not only an infection but a lifelong condition.
People living with HIV who have access to testing and treatment can now expect to live as long as the general population — but their life experience is still marred by the stigma and marginalisation associ-ated with HIV. Prevention, testing
and treatment are all undermined by such social factors.
People living in the UK benefi t from a highly eff ective scientifi c and medical response to HIV. The NHS provides excellent HIV treatment services which have among the best outcomes in the world. New options for HIV prevention and testing are in the pipeline. Yet certain groups in our community continue to be dis-proportionately aff ected by HIV: gay and bisexual men (of whom one in 20 is living with HIV) and black African men and women (one in 26).
There is a strong association be-tween HIV and social deprivation, especially in London, where diag-nosed HIV prevalence is as high as 8 per 1,000 in the most deprived ar-eas and less than 1.5 per 1,000 in the least deprived areas. HIV clinics in-creasingly report patients who have access to treatment but cannot af-ford the food they need to stay well. These are challenges we must ad-dress together, as a society. We have come so far in the fi ght against HIV, but there is so much left to do.
Sarah Radcliffe, policy and
campaigns manager, NAT
“Phenomenal scientifi c
advances have
been made in our
understanding of how
these diseases work,
how to prevent and
how to treat them”
CHALLENGES
DIGITAL EXCLUSIVES
COMMUNICABLE DISEASES1ST EDITION, DECEMBER 2014
Managing Director: Carl SoderblomContent and Production Manager:
Faye GodfreyBusiness Developer: Alex Williams
Responsible for this issueProject Manager: Antonia Street
E-mail: [email protected]
Mediaplanet contact information: Phone: +44 (0) 203 642 0737
E-mail: [email protected]
LIVING WITH HEPATITISCelebrity chef and food writer, Gizzi Erskine
offers options for a ‘liver friendly’ diet
FOR EXTENDED,
INTERACTIVE,
AND EXCLUSIVE
CONTENT VISIT
MEDIAPLANET UK#communicablediseases
communicablediseases.co.uk
MEDICAL ADVANCEMENTSRecent trials into a HIV vaccine are
showing promising signs of success
Specialist Biotech company, based in Switzerland and the Netherlands, focused on R&D of safe preventative vaccines against human infectious diseases. Unique proprietary virosome technology platform combined with leading viral membrane protein know-how and expertise to develop safe and effective life improving vaccines.
Vaccine Pipeline:• Respiratory Syncytial Virus (RSV) (out licensed)• intra-nasal Influenza (Phase I)• HIV (Phase I)• Malaria (Phase I)• Herpes Simplex Virus (HSV) (pre-clinical stage)
Mymetics is listed on OTCQB: MYMX. Venture stage market place for early stage companies current in SEC reporting.
Vaccines for Tomorrow
Mymetics BV: Leiden, The Netherlands - Tel. +31 71 332 2130Mymetics Intl.: Epalinges, Switzerland - Tel. +41 21 653 4535
www.mymetics.com
WORLD AIDS DAYDr Christian Jessen explores the barriers
we still face in the fi ght against AIDS
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“For too long, tuberculosis has not received the public attention and prioritization needed to prevent the nine million cases and 1.5 million deaths that the World Health Or-ganization (WHO) says occurred in 2013,”1 says Dr Evan Lee, vice pres-ident of Global Health Programs at pharmaceutical company, Eli Lilly and Company.
It is estimated by WHO that about a third of the global population car-ries latent TB.2 Most never devel-op the full blown disease, which is spread through coughing and sneez-ing.2 It is people with compromised immune systems, such as those with HIV, malnutrition or diabetes, who have a much higher risk of falling ill — and spreading the disease.2 WHO statistics show that 95 per cent of all cases occur in the developing world.2
The good news is that the estimated number of people falling ill each year with TB is declining.2 However, the ris-es since the late 1990s of TB with mul-tidrug-resistance (MDR-TB) threatens progress. Last year, the WHO estimat-ed that there are around 480,000 new cases of MDR-TB per year, which occur when cases don’t respond to two or more first-line medicines.1 MDR-TB is much tougher to cure1 and requires up to 20 months of therapy.1
Tackling MDR-TB with Technology TransferIndependent researchers looking into the issue discovered that two medicines, already produced by Lil-ly, were effective in treating drug-resistant TB.3 In response, Lil-ly doubled production and subsi-dised prices of the medicines. With global demand projected to quickly outpace manufacturing capac-ity, Lilly looked at an alternative
way of sustainably getting the medicines to those who needed it through ‘Technology Transfer’.
By giving away manufacturing know-how and rights to income, and finding in-country partners to manufacture the medicines — es-pecially in MDR-TB hotspots such as China, India, Russia, South Af-rica3 — Lilly hoped to help people and communities in need, whilst reducing production and delivery
costs. It was a bold decision, quite unprecedented in the industry and yet it was strewn with obstacles and important learnings.
While the process of transfer-ring manufacturing technology to partners committed to interna-tional quality standards has taken years, Lilly has established a sus-tainable, high quality supply of these medicines in important are-as. Lilly’s model of sharing knowl-edge through Technology Trans-fer and collaboration is one from which Dr Lee hopes others in-volved in the fight against MDR-TB can learn.
“Just as MDR-TB requires a mul-tidrug approach to combat per-sistent TB infections, the global health community must come to-gether behind a multi-sectoral ap-proach — governments, civil socie-ty, the private sector, academia and NGOs — to battle all aspects of this disease,” concludes Dr Lee. “Hope-fully our experience will trigger ac-tion among other entities and en-courage other companies to act. I’m cautiously hopeful, but a lot more needs to be done.”
Advances in fight against multidrug-resistant tuberculosis
COMMERCIAL FEATURE
TECHNOLOGY TRANSFERLilly looked at an alternative way of sustainably getting medicines to those in need through Technology Transfer — the process of transfering manufacturing technology to partners committed to international quality standardsPHOTOS: ELI LILLY AND COMPANY
CONQUERING MULTIDRUG-RESISTANT TB (MDR-TB) THROUGH EDUCATION AND ACCESS TO MEDICINE
Since 2003, Lilly has worked hand in hand with local and global partners to prevent MDR-TB from gaining ground and taking more lives. The Lilly MDR-TB Partnership brings together government leaders, global health organizations, country-level healthcare providers, community and advocacy organizations and other stakeholders to increase the availability of quality-assured medicines used to treat MDR-TB, enhance education for healthcare professionals where the need is greatest, and raise awareness of the disease amongst communities most at risk.
It all began with an innovative program – transferring medicine manufacturing technology to local companies in MDR-TB ‘hot spots’- learn more at www.LillyGlobalHealth.com/mdr-tb.
WHITE PAPER
Seeking Solutions to a Global Health CrisisEli Lilly and Company’s Technology
Transfer for Multidrug-Resistant
Tuberculosis Medicines
■ Question: How do you fight
multidrug-resistant tuberculosis
(MDR-TB) and TB, the world’s
second largest killer?
■ Answer: A new approach to
global collaboration that makes TB
medicines more readily accessible
for those who need them most.
REFERENCES:
1. WHO Global Tuberculosis Report 2014 — page 17 - http://apps.who.int/iris/bitstream/10665/137094/1/9789241564809_eng.pdf?ua=12. WHO Tuberculosis Facts — http://www.who.int/mediacentre/factsheets/fs104/en/3. ‘Seeking Solutions to a Global Health Crisis’ — page 6, 11 — http://www.lillyglobalhealth.com/Publications/Whitepaper-Lilly_MDR-TB_Technology_Transfer_Oct_2014.pdf
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■ Peter Williams founded British clothing company Jack Wills in 1999 when he was in his twenties. There are now more than 80 stores in the UK and overseas with the registered trademark, ‘Fabulously British’. Williams is patron of British charity Malaria No More UK.
When the best of British values are applauded by Bill Gates it strikes a chord with me. Even more so when it includes a focus on the transfor-mational impact of overseas aid and the huge progress in the fi ght against malaria, an issue close to my heart. At a unique event last month hosted by the Lord Speaker — entitled The Case for Aid: A Con-versation with Bill Gates1 — two core British values were stressed by one of the world’s leading busi-nessmen and philanthropists: gen-erosity and leadership. The UK pub-lic has shown extraordinary gen-erosity and have made the UK an international leader in promoting
primary healthcare for all. After all, the public’s response to the latest Disasters Emergency Committee appeal for Ebola has raised a stag-gering £17 million so far.
And when it comes to malaria, one of the strongest proof points that aid works is that progress in malaria has been unprecedented in the past 15 years, seeing child deaths cut in half since 2000.2 When it’s the one disease that has killed more children than any other in history (a child every minute), that feels like palpable progress indeed.
British supportAs Mr Gates rightly pointed out, British public support for helping to improve the health and lives of those in the world’s poorest coun-tries has long been a tradition we should rightly be proud of. Even in harder economic times it appears this sense of duty to help others re-mains — a poll last year showed that 81 per cent of the British public be-lieves the UK should be helping sup-port the world’s poorest countries.3
More specifi cally, in recent opinion polling by Malaria No More UK, 70 per cent of the UK public believed malaria is a serious development is-sue. And I agree, both as a father, be-cause no parent should suff er the horror of the loss of their child from a disease that we can beat, and also as a businessman, because there are many reasons to see how strategi-cally important ending malaria is.
A smart business investment is one that gives a good return, and the same applies to aid — some-thing that malaria does convinc-ingly. With the World Health Or-ganisation rating malaria in-terventions as the second most cost-eff ective health interventions after childhood immunisation,4 and estimates that every US$1 in-vested in malaria control in Africa, on average, returns US$40 in high-er economic growth,5 suffi ciently funding malaria for the long-haul makes for a strong business case. Recent research shows that the world stands to gain an estimated US $208 billion by 2035 due to the
tremendous health and produc-tivity gains that would be made.6 Clearly a smart investment. And as Bill Gates reinforced, history shows us that we need to be decisive about malaria because more tentative ap-proaches don’t work. The only way to stop malaria is to end it forever.
Finally, as Bill Gates alluded to, with malaria it’s still all to play for, as we are at a turning point in the fi ght against the disease and there is a re-al sense of jeopardy. Whether the as-tonishing progress of recent years will continue to shrink the malaria map country by country, or if the tide turns the other way with the risk of massive resurgence, depends on whether support and funding con-tinues at the level that is required. The businessman in me — and the father — says: let’s get the job done.
Read more about how Jack Wills is working to help defeat malaria at www.communicablediseases.co.uk
GENEROSITY AND LEADERSHIP IS AIDING UNPRECEDENTED PROGRESS IN MALARIA
PETER WILLIAMS
FOUNDER, JACK WILLS
patientuk@patientukSearch ‘flu’ on patient.co.ukfor our flu myths and more!
NEWS
PHOTO: (C) M. HALLAHANSUMITOMO CHEMICAL - OLYSET NET 1
1 http://www.parliament.uk/business/news/2014/october/lord-speaker-bill-gates-visit/....2 http://www.who.int/malaria/publications/world_malaria_report_2013/en/....3 http://ec.europa.eu/public_
opinion/archives/ebs/ebs_405_fact_uk_en.pdf...4 http://www.rbm.who.int/gmap/2-5.html...5 http://www.forbes.com/sites/skollworldforum/2013/04/25/world-malaria-day-2013-we-cannot-aff ord-to-
wait/http://www.interaction.org/choose-to-invest-2015/malaria...6 http://www.rbm.who.int/worldmalariaday/_docs/wmd2014-Key-messages.pdf
Vector Control DivisionLeading Innovation in Vector Control
www.sumivector.comRegistered trademark of Sumitomo Chemical Co., Ltd.
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By raising awareness, securing funding, training healthcare work-ers and quantifying the need, Med-icines for Malaria Venture (MMV) and partners are increasing the up-take and use of injectable artesu-nate across the malaria-endemic world, starting with Nigeria.
Saudat’s story: small ripples can make big wavesSaudat was three years old when she was admitted to Murtala Mo-hammed Specialist Hospital (MMSH) in Kano state, Nigeria. She was unconscious, with convulsions and a temperature of 38.9C. She had severe malaria. Her life was at risk.
Injectable artesunate was admin-istered immediately, and then regu-larly for a period of 48 hrs. Two days later, Saudat gained consciousness
and was put on a regimen of ar-temether-lumefantrine, an oral ar-temisinin combination therapy (ACT), to cure her. Injectable artesu-nate had helped reduce the severity of malaria and saved her life.
“Working in malaria, and especial-ly in access and delivery of antimalar-ials, is challenging,” said Pierre Hugo, a member of MMV’s access and deliv-ery team. “Seeing Saudat recover so quickly was amazing. It’s hugely sat-isfying to see a product that we have supported put to use, and truly hum-bling to meet the healthcare provid-ers who save lives on a daily basis.”
Injectable artesunate is a prod-uct of Guilin Pharmaceutical. MMV helped Guilin bring its production to standards required by WHO for prequalifi cation. In November 2010, injectable artesunate was granted
prequalifi cation by the WHO. Since then, MMV and Clinton Health Access Initiatives (CHAI) have been working to increase the uptake and use of this life-saving medicine in Nigeria.
Dr Binta, head of paediatrics at MMSH, the busiest referral hospital in Kano, a state in northern Nigeria, in-formed MMV that, based on Saudat’s and a handful of other cases’ positive response to treatment, her depart-ment has switched to injectable ar-tesunate for all admitted cases of se-vere malaria. Furthermore, the Hos-pital Management Board has started to procure this life-saving medicine for other hospitals in the state to treat many more severe malaria patients — small ripples can make big waves.
There are around 5.6 million cases of severe malaria every year, leading to around 627,000 deaths, mostly of children under five. In 2011, the World Health Organization (WHO) recommended injectable artesunate as the preferred treatment — it saves more lives than previous medicines. The problem is many health facilities in malaria-endemic countries still use old treatments.
Severe malaria: Scaling up life-saving treatment
ELIZABETH POLL
Editor and Publications Offi cer, MMV
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Defeating Malaria Togetherwww.mmv.org
More investment needed to continue malaria battle
Resistance to insecticides used to kill malaria-carrying mosquitoes is threatening to reverse gains made in fighting the disease. According to the World Health Organi-zation (WHO), malaria deaths fell by 45 per cent between 2000 and 2012, thanks to greater use of long-lasting insecti-cide-treated bed nets (LLINs), more ef-fective treatment, more homes being sprayed with insecticide — indoor re-sidual spraying (IRS) and better health-care. However, continued use of the same pesticides has led mosquitoes to develop insecticide resistance.
According to WHO, LLINs and IRS are estimated to avert about 220,000 deaths in children under fi ve in Africa every year. If pesticides lose their eff ective-ness, more than 55 per cent of the ben-efi ts would be lost.
“It’s been over 30 years since a new in-secticide was launched on the market, so the world needs to look for alternatives,” says John Invest, technical consultant at Vector Management. One approach is rotating pesticides used in indoor spray-ing; another is using new bed nets con-taining a synergist that blocks the mos-quito’s ability to produce enzymes that detoxify the insecticide.
Neither is easy and both are costly, but with a child dying from malaria every minute, Invest warns: “We can’t be com-placent. We need to act before the number of deaths from malaria start to rise.”
KATE SHARMA
Saudet (pictured) is lucky to be alive after suffering from severe malaria aged threePHOTO: MMV
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Community health volunteers in some of the world’s most remote regions are playing a crucial role in preventing and diagnosing malaria before it’s too late.
“I was not feeling well. I was vomit-ing and shaking,” explains Ku Saw Reh, who lives in the remote village of Daw Khu Li in Kayah state, east-ern Myanmar. Ku Saw Reh’s situation is familiar to many in Myanmar who live with the constant threat of ma-laria. According to the World Health Organization, more than 40 million people in Myanmar live in malaria- endemic areas and, in 2010 alone, the country reported 650,000 cases.
A simple blood test saves livesHowever, thanks to the success of a local healthcare project, supported by Christian Aid, communities in Myanmar are fighting back against the might of malaria.
It’s all thanks to lifesavers like 25-year-old Mi Myar. Mi Myar is a
village health volunteer. Trained by a local Christian Aid partner, she plays a vital role in helping to reduce mor-bidity and mortality rates in Daw Khu Li. She raises awareness around good health and hygiene practic-es, distributes insecticide-treated
mosquito nets, and can spot the signs and symptoms of malaria.
In addition, she has been taught how to carry out a simple blood test, using a rapid diagnostic testing kit. Previously, cases of malaria often went undetected and now, thanks to testing, these cases
are being diagnosed much earlier, meaning that people like Ku Saw Reh receive treatment as fast as possible.
Mi Myar is one of 1,844 trained and trusted volunteers who are serv-ing their communities and show-ing how very simple changes in
behaviour — such as using a mos-quito net, maintaining a clean home and seeking medical help when you feel unwell — can make a huge dif-ference. “You have to change peo-ple’s way of thinking to make them see how important these things are,” she explains. “With the skills I’ve learnt and the support I’ve re-ceived, I believe I can do this, if not instantly, then certainly over time.”
Thanks to her intervention, Ku Saw Reh is now on the road to re-covery. He remains unable to work, which puts huge pressure on his wife and their five-month-old daughter, but, without Mi Myar’s swift inter-vention, the cost could have been even greater. “I think the project is saving lives,” she says, proudly. “The people I have examined and referred are better now. They are well. The outcomes might have been very dif-ferent, without a referral.”
Healthcare at the heart of the community
Mi Myar (pictured) is a village health volunteer. Trained by a local Christian Aid partner, she plays a vital role in helping to reduce morbidity and mortality rates in Daw Khu Li.
KATE SHARMA
Photos: Christian Aid / Kaung Htet
MALARIA KILLS A CHILD EVERY 60 SECONDSText £3. Send a net. Save a life.In the next 60 seconds, you could help buy a net and save a child’s life with a gift of just £3.
A chemically treated mosquito net is the best way to protect a child from one of Africa’s biggest killers*. And we desperately need more of them. £3 is enough to buy a sandwich here. But in Africa, where malaria kills a child every 60 seconds, your £3 could help buy a net and save a young life.
TEXT NETS TO 70555 TO GIVE £3 TODAY
This is a charity donation service for Christian Aid. You’ll be charged £3 + 1 standard rate message. Christian Aid will receive 100% of your donation. We may contact you again in future. If you would prefer that we didn’t call you, text NOCALL CA to 70123. If you would prefer not to receive SMS messages from us in future text NOSMS CA to 70123. To discuss this payment call 0203 282 7863. Ensure you get the bill payer’s permission before making a donation. All of your gift will go to support our frontline work with the world’s poorest communities. *Source: World Health Organization April 2010.
UK registered charity number 1105851 Company number 5171525 Scotland charity number SC039150 NI charity number XR94639 NI company number NI059154. The Christian Aid name and logo are trademarks of Christian Aid; © Christian Aid November 2014.
From protecting children against malaria to ensuring poor communities receive the vital services we take for granted, your gift will help fund our work to eradicate poverty.
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NEWS
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Images of body-bagged victims, health professionals in protective suits and communities gripped with fear have come to epitomise the current Ebola crisis. In countries such as Liberia, public information campaigns have helped to calm the initial panic, but life is far from normal with schools closed, people unable to get to work, healthcare disrupted and the constant threat of a killer in their midst.
“No doubt the world has been slow to respond,” says Marion O’Reilly, Ox-fam’s head of Public Health Promo-tion, who’s just returned from West Africa. “It’s taken us by surprise be-cause other outbreaks have been in rural areas where medical organi-sations, working with local health authorities, have been able to close them down quickly.”
The latest outbreak started in Guinea but, unlike previous cases, it spread across borders into urban areas where dense populations and poor healthcare exacerbated the problem. With no cure, patients are isolated to stop infection spreading and given fluids and pain relief to try to keep them comfortable.
Community actionHowever, according to O’Reilly, the key to tackling Ebola doesn’t just lie with medical professionals.
“There is still a need for more treat-ment centres,” she says, “But peo-ple have to be willing to use them. Early on there was a lot of fear and
misunderstanding. We need trust-ed members of the community and local authorities to help people act to reduce the chance of their com-munities getting infected.”
Oxfam is helping to make this hap-pen by providing information on how to prevent infection and what to do if someone catches the virus. Door-to-door visits by community health workers and radio adverts are backed up with the distribution of hygiene kits, including soap and bleach.
On the ground, O’Reilly has seen communities tackling Ebola head on. “In Liberia, one of our staff was telling me how his neighbours made their own task force,” she says. “When someone got Ebola, he led his community in planning how to stop the infection spreading. I’ve also heard of people who’ve sur-vived going back to treatment cen-tres to help out any way they can.”
In addition to the tragic human cost, the World Bank estimates the economic cost of Ebola to West Africa could be as high as $32.6bn (£20.2bn) by the end of 2015. It’s clear that the full extent of the crisis is yet to be seen and O’Reilly warns, “we can’t hold back on the efforts”.
More action is needed fast to save Ebola victims
Naomi Kollie, an Oxfam community health volunteer, talks to communites about Ebola prevention in Clara Town PHOTO: PABLO TOSCO / OXFAM
KATE SHARMA
First trials for Ebola treatments to start in DecemberMédecins Sans Frontières (MSF) recently announced it would host clinical trials in three Ebola management centres in West Africa to find a successful treatment for Ebola. To date the disease has killed over 5,000 with a high fatality rate.
A French team will trial one antiviral drug, Favipiravir, while the Universi-ty of Oxford will lead a second trial on another, Brincidofovir. The Antwerp Institute of Tropical Medicine will test a convalescent blood and plasma therapy offering sufferers antibodies in blood transferred from survivors. None of the trials will be using pla-cebos for ethical reasons. WHO and the local health authorities are fully involved and the trials will attempt to target a 14-day survival observing international medical standards and the sharing of sound scientific data. Trials are set for December and it is hoped that first results will be avail-able in February 2015.
“This is an unprecedented inter-national partnership which repre-sents hope for patients to finally get real treatment,” said Dr Annick An-tierens from MSF. Meanwhile MSF is urging the drugs’ developers to scale up production now, to ensure there is no gap between the end of trials and the introduction of safe and effective products at prices affordable to the sufferers in Africa.
ZOË MAYERS
SEND HYGIENE
KITS AND SAVE
LIVES NOW
We need to stop the spread of Ebola, before it’s too late. A simple hygiene
kit – including bleach, a bucket, soap and other essentials – could protect
a vulnerable family. Please give whatever you can and help save lives.
EBOLA CRISIS
APPEAL
Registered charity in England and Wales (no. 202918)
If we raise more money than is needed for the project, the extra funds will be used wherever the need is greatest. We would like to tell you more
about our work. If you don’t want this information, email [email protected], phone 0300 200 1300 or write to Supporter Relations, Oxfam,
2700 John Smith Drive, Oxford Business Park South, Oxford OX4 2JY.
2014EXF011
£16 could buy two hygiene kits now
Here is my gift of £16 £25 £50 Other
I enclose a cheque made payable to: Oxfam Ebola Crisis Appeal OR
Please debit my Visa/Mastercard/Maestro/CAF Charity Card with the amount
specified (We cannot accept Solo cards)
Title Forename Surname
Address
Postcode
Signature Date
Card Number (Maestro only)
Start Date Expiry Date Issue No
CALL 0300 200 1999www.oxfam.org.uk/appeal
Please detach and return to: Freepost RLXG-GGBC-ZBYE, Oxfam, 2700 John Smith Drive, Oxford Business Park South, Oxford OX4 2JY.
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FACTS
■ Ebola virus disease (EVD) first
appeared in 1976 in two simultaneous
outbreaks, in Sudan and Democratic
Republic of Congo.
■ There have been more cases and
deaths in this outbreak of Ebola than
all other outbreaks combined.
■ The most severely affected
countries are Guinea, Sierra Leone
and Liberia.
■ Ebola spreads through human-
to-human transmission via direct
contact with the blood, secretions,
organs or other bodily fluids of
infected people, and with surfaces
such as bedding and clothing
contaminated with these fluids.
SOURCE: World Health Organization
INSIGHT
